Psychology

There are several theoretical approaches to crisis intervention. They are not long term in duration and are not for chronic psychological problems but are aimed toward acute disturbances. The theoretical approaches fall under crisis intervention. This includes suicide hotlines, hospital crisis centers, and mental health professionals. Suicide hotlines are generally manned by volunteer services. These calls are very serious in nature and professional mental health workers are available to assist the volunteers to ensure that each call is handled as a medical crisis appropriately. All calls are completely confidential. However, depending on the call, if it appears that the caller is going to commit suicide at the moment, a professional mental health counselor will take the call to attempt to talk the caller out of it, and to seek immediate medical help (Moore, 2001).

Hospital crisis centers are where persons who pose an immediate threat to self, or to others are placed. They are admitted to the hospital in a psychiatric ward where they are evaluated. Patients consist of suicidal, homicidal, and those committing violent acts as a result of drug influence. Treatment is decided upon by the psychiatrist. Mental health professionals are involved in assisting patients involved in traumatic events. These events include war, airplane crashes, rape, car accidents, school shootings, armed robberies, etc... Traumatic response to an event may take up to several years to manifest. Intervention by mental health professionals may offset symptoms by alleviating the fear associated with the event. They use a technique known as psychological debriefing which is still being investigated as to its effectiveness, as there are questions in association with this technique possibly causing more harm than good for some patients. The target is to keep patients from developing post traumatic stress disorder as in most cases the patient may only suffer from acute stress disorder without developing post traumatic stress disorder in light of the intervention (Moore, 2001),

Describe the 6-Step Model of Crisis Intervention.
The 6 steps are an integrated problem solving process which enables counselors to effect crisis intervention in a direct manner as a straight forward approach. The model was effected in a time when more individuals were seeking mental health treatment. Long term psychotherapy was quite costly and the 6-step model was targeted for short term psychotherapy that would be an affordable crisis intervention tool (Chechak, 2007).

The 6-step Model of Crisis Intervention is
Defined the problem
Understanding client s problem
Perspective
Ensure client s safety
Minimize physical and psychological danger to self and others
Provide support
Convey concern for the client
Examine alternatives
Situation support
Coping strategies
Positive thinking
Make plans to restore clients  equilibrium
Work in collaboration with client to enhance control and autonomy
Obtain client commitment to make positive steps

Describe the SADPERSON Model of risk, and myths associated with suicide. Why is it important to understand this information

SADPERSON Model scales are Sex, age, depression, previous attempt, ethanol abuse, rational thinking loss, social supports lacking, organized plan, no spouse and sickness. The most risky individual is Male, youth (15-24) and elderly, has an alcohol or chemical dependency problem, can not cope or does not know how to cope crisis, isolates self from family, friends, or society and has terminal illness.

Myths Associated with Suicide
People come up with things to say to make others directly affected by the suicide feel better. Some things that are said like  No one could have done anything to stop it  or  In time the pain will fade  these are totally unfounded, and are therefore considered as myths. There is always the chance that intervention could have stopped a suicide, and the truth is that grief associated with suicide is much harder to come to terms with than deaths of any other kind. The saddest myth about suicide is one that suicidal individuals tell themselves  no one will care.  (Salvatore, 2009).

There are ten major factors of risk associated with a SAD PERSONS evaluation. This scale represents patterns associated with suicide risk. Studies show that medical professionals who follow the SAD PERSON scale are more effective in accurately determining those at low or high risk for suicide. This allows for correct and expedient disposition for treatment accordingly (Patterson et al, 1983).

Describe the diagnostic category of Posttraumatic Stress Disorder (PTSD) including symptoms, populations at risk, and treatment options. Why is this important when working with crisis intervention

An evaluation to identify and determine specific symptoms is relevant in initiating a clear and concise diagnosis for treatment. Symptoms that professionals look for include stress related responses. Stoppler (2010) expresses the physical impact of stress on the nervous system and its contribution to other bodily dysfunctions. Physical attributions are raised blood pressure, suppression of the immune system, increased risk of heart attack and stroke, contribution to infertility, and age progression.

ICBS (2007) provides the emotional signs and symptoms of stress. These symptoms allude to an emotional disorder that could, depending on severity and time, constitute a diagnosis of ASD apparent within a month of the event and short lived, or that of a posttraumatic disorder, which is chronic. These symptoms include irritation, anger and hostility, depression and withdrawal, jealousy, restlessness and anxiousness, decreased initiative, inability to be reality based or overtly alert, decreased personal involvement, crying bouts, critical depiction of others, self-deprecating, nightmares, and weak reflexes of emotional responses.

The most common behaviors associated with ASD are easily recognizable according to Aetna (2007). Such behaviors exhibit frequently and increase in frequency if intervention does not occur. Recurring behaviors include nail biting, increased smoking, or use of alcohol and drugs, neglect of responsibility, poor job performance, and poor hygiene.

Primary indicators of ASD associated with life and death or serious injury occurs within four weeks of the traumatic event. If the symptoms persist, the individuals assessment for PTSD (posttraumatic stress disorder) indicates that the disorder may be deep rooted in a history of events, which likely stems from childhood. A study of PTSD tested 243 children injured in various car crashes. The research provided results of  eight percent of children met the symptom criteria for ASD and another 14 had subsyndromal ASD 6 met the symptom criteria for PTSD and another 11 had subsyndromal PTSD. ASD and PTSD symptom severity were associated  (Kassam et al, 2004).

The unknown factor of ASD is in accordance with its construct. The Symptomology is known as stress reactions inclusive of  dissociation, reexperiencing, avoidance, and arousal. Research findings confirm the four associative reactions pursuant to ASD and development of PTSD however, studies are needed to find what causes the reactions to manifest (Brooks, 2008).

Significant Factors in Differential Diagnoses
In light of the results of this study, it is indicative that the possibility of the 6 meeting the criteria for PTSD, could have suffered from it as a child lacking diagnosis. The conduction of further studies into the 6 of children is in need to confirm this hypothesis. The answer to the question of a diagnosis of ASD as a predictor of PTSD was inconclusive. Other relevant studies conducted on children examined diagnosis of ASD, with predictability of PTSD resulting from assault, or motor vehicle severity of injury. The results confirmed that ASD was a  good predictor of later PTSD but that dissociation did not play a significant role  (Meiser, 2005). In addition, another study of children diagnosed with ASD using the intervention of pharmacological treatment performed to evaluate for prevention of PTSD. Study involved three symptom clusters to analyze history of events. ASD Symptomology provided beneficial data in depicting lack of onset of PTSD versus ASD parameters with pharmacological treatment (Adler et al, 2005).

An interesting study involving rescue workers brought to light the connection of ASD with PTSD. The results indicated that prolonged Symptomology to ASD was evident in the development of PTSD. The study tested participants at 2 months, 7 months, and at 13 month, intervals. The participants were comprised of directly exposed to disaster, and of those indirectly exposed to disaster. Those with direct exposure ranked  7.96 higher on developing PTSD, and being depressed at 18 months  (Fullerton, 2004).

Etiological Factors and Assessment Issues Involved in Acute Distress Disorder
When we look at etiological factors such as in the case of combat related trauma, views are that PTSD is a normal reaction. The evaluation on a case study on the development of PTSD in relation with the concept of  war neurosis  comparative to combat fatigue and shell shock parameters indicated wide spread affect. It was decidedly adapted to be representative of all combat personnel. Configurative measures are unclear as to the use of one source in the determination however, the expectation of the disorder affecting all combat soldiers preempt both a combination of psychotherapy and pharmacological treatment (Bracha, 2006).

In looking at combat related trauma, which involves direct and indirect association with extreme violence, there is increased knowledge of the connection between mental health issues, and massive violence of various natures and degrees. Of evaluations conducted regarding psychiatric disorders, top of the list were acute stress disorder and posttraumatic stress disorder. The cross mix of symptoms were relative to various disorders but representative of key elements of ASD and PTSD (Murthy, 2007). Murphy also advises of associative and comparative symptoms including bereavement, depression, fear, poor physical health, anxiety, physiological arousal, somatization, anger control and function disability, and the arrest or regression of childhood development progression.

The impact stemmed from the amount of pain severity and loss of body parts in correlation with the increased numbers of those afflicted and diagnosed. For this reason, measures taken to expand on the  variety of symptoms  will be applicable for future studies (Murthy, 2007).

Identify Dominant Treatment Modalities
Modalities in place in attribution of treatment of ASD are psychotherapy and pharmacology, prescribed separately, or a combination of both may apply. It all depends on the individual diagnosis and response. There have not been many studies on the effects of pharmacological treatment on patients, but from those conducted it is known that the administration of serotonin reuptake inhibitors prove invaluable in providing quality of life to those who need treatment (Seedat, 2006).

Ponniah and Hollon (2009) speaks on Cognitive Behavior Therapy (CBT) and eye movement desensitization and reprocessing (EMDR) as efficacious and specific for PTSD   it has made monumental progress in going forward, in addition to  stress inoculation training, hypnotherapy, interpersonal psychotherapy, and psychodynamic therapy introduced as having great possibilities in treatment of PTSD (Ponniah  Hollon).

As research has pointed to the affliction of development of ASD, and PTSD, in association with childhood trauma and the cognitive and physical response relays into adulthood. It is interesting to note that psychotherapy treatment for children is not common. Psychotherapy treatment is provided to adults in relation to current ASD, or PTSD factors. Yet, it is provided to children in relation to  single-incident trauma  such as sexual abuse, with such treatment modalities as  cognitive behavior therapy (CBT), eye movement desensitization and reprocessing (EMDR), and play therapy  (Adler et al, 2005).

This may be due to the difficulty in diagnosing young children with regard to ASD, and PTSD, as in a 4 year old, they tend to be quite subjective communicatively. Changes in DSM-IV criteria with regard to the three clusters in alternative criteria that are focused on consistent behavior patterns and sensitivity in connection with development will assist in determining diagnosis of PTSD (Adler et al, 2005).

Traumatic events that can lead to post-traumatic stress disorder (PTSD) include
War
Rape
Natural disasters
A car or plane crash Kidnapping
Violent assault
Sexual or physical abuse
Medical procedures (especially in kids) Symptoms of post-traumatic stress disorder (PTSD)

Following a traumatic event, almost everyone experiences at least some of the symptoms of PTSD. It s very common to have bad dreams, feel fearful or numb, and find it difficult to stop thinking about what happened. But for most people, these symptoms are short-lived. They may last for several days or even weeks, but they gradually lift.

If you have post-traumatic stress disorder (PTSD), however, the symptoms don t decrease. You don t feel a little better each day. In fact, you may start to feel worse. But PTSD doesn t always develop in the hours or days following a traumatic event, although this is most common. For some people, the symptoms of PTSD take weeks, months, or even years to develop.

The symptoms of post-traumatic stress disorder (PTSD) can arise suddenly, gradually, or come and go over time. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell. While everyone experiences PTSD differently, there are three main types of symptoms, as listed below.

Re-experiencing the traumatic event
Intrusive, upsetting memories of the event
Flashbacks (acting or feeling like the event is happening again)
Nightmares (either of the event or of other frightening things)
Feelings of intense distress when reminded of the trauma
Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)
PTSD symptoms of avoidance and emotional numbing
Avoiding activities, places, thoughts, or feelings that remind you of the trauma
Inability to remember important aspects of the trauma
Loss of interest in activities and life in general
Feeling detached from others and emotionally numb
Sense of a limited future (you don t expect to live a normal life span, get married, have a career)
PTSD symptoms of increased arousal
Difficulty falling or staying asleep
Irritability or outbursts of anger
Difficulty concentrating
Hypervigilance (on constant  red alert )
Feeling jumpy and easily startled
Other common symptoms of post-traumatic stress disorder
Anger and irritability
Guilt, shame, or self-blame
Substance abuse
Depression and hopelessness
Suicidal thoughts and feelings
Feeling alienated and alone
Feelings of mistrust and betrayal
Headaches, stomach problems, chest pain

Discuss interesting points of information that you learned from this class, and potential opportunities for future use.

I have learned that we are all vulnerable and it is okay to have a weak moment. However, it is very important to recognize our weaknesses, and to care for ourselves before it becomes too late. Our social supports, such as friends, family and even strangers are very important to have in our lives. Taking care of each other will enable healthy minds, and relationships, which is the key to having a healthy lifestyle. In the future, I will pay more attention to my own emotional stage and ask for help if necessary. I will also do the same for my family, friends and if necessary, strangers.